For this discussion, the region surrounding the anus (opening of the anal canal) including the area between the anus and the genitalia (called perineum) is called ‘anal region'. Some times referred to as perianal region.

What is SEAR?

Regularly inspecting and feeling the ‘anal region' (see above) by a person himself or herself to detect any abnormalities at an earlier stage. In this discussion, the focus is on finding out any early signs or abnormalities related to sexually transmitted infections in the anal region.

Who should perform SEAR?

Anyone who is sexually active and who practice anal sex or ‘thigh sex' (inter-crural sex) can periodically perform SEAR. However this guide is primarily for men who have sex with men and transgender women (male-to-female transsexuals/transgender) who practice anal sex.

Why perform SEAR? Why not just go to a doctor?

Performing SEAR means you are taking care of the health of yours and your partner(s). A basic knowledge of how a normal anal region looks and feels like will help you to easily recognize any signs of change or illness in the anal region and take action before the condition becomes serious. Once you detect any abnormality - say a small growth suggestive of anal warts - then you need to go to a doctor. Hence SEAR is NOT a substitute for going to your doctor for a detailed examination or diagnosis.

What do I look for in SEAR? What are the abnormalities?

You should look for any changes or abnormalities in the anal region. These may include the appearance of warts, lumps or growths of any kind; ulcers or sores; blisters; areas of pain, inflammation (redness) or itching; and discharge from the anus. If you have any of these changes, or have any queries you need to contact your doctor. Note that early diagnosis (detection) can lead to an early cure.

How do I do self-exam?

A SEAR may take approximately 10 to 15 minutes to perform.

Ensure that your hands are clean (wash with soap) and dry. If possible, you can use disposable gloves.

Find a comfortable and private space (bedroom or bathroom) where you will not be disturbed and you feel relaxed.

For better view of the entire anal region, you need to use a hand mirror and a flashlight. Keep everything you need within easy reach.

You need to sit with your anal region facing the source of light (or you can use a flashlight/'Torch')

Using your bed, sit on the bed with your back against the wall or bed headrest. You can prop yourself up with pillows. (If you have a long wall mirror, sit on an arm-chair in front of that mirror).

Spread your legs wide apart.

Hold the hand mirror in one hand and with the other hand expose the anal region if not already visible. Move the male genitalia upwards (lift the scrotal sacs/penis) and examine the area in between the genitalia and the anus (perineum). Examining the perineum is thus easier in post-operative transsexuals and Hijras/Aravanis who have undergone emasculation (removal of the entire male genitalia).

In obese persons, it may be difficult to see the anal opening and the flabby thighs need to be separated away from the midline.

As you see the anus – look for the changes or abnormalities listed above.

Besides inspection, you may also feel the anal region to detect any lumps or change in the skin texture.

After SEAR, wash your hands with soap and dispose of any gloves, if used.

How frequently should I do SEAR?

All sexually active persons who practice anal sex can perform SEAR at least once a month or if they feel any discomfort in the anal region.

Regularly inspecting and feeling one's own genitalia by a male to detect any abnormalities at an earlier stage. In this discussion, the focus is on finding out any early signs or abnormalities related to sexually transmitted infections (STI) in the male genitalia.

What are the direct Benefits of GSEM?

Most of the sexually transmitted infections can be completely cured and the suffering can be lessened if detected earlier. Yet, it is quite common for men to have STIs and not be aware of it since some STIs are not painful (or itchy). If the man thinks he has no problem, he will not take treatment. Thus, in continuing to have unprotected sex with his male or female partner(s) he could pass on the STIs to them and he also increases his likelihood of acquiring or transmitting HIV, which gets transmitted more easily when STIs are present. Thus, by performing GSEM on a periodic basis one can detect STIs (with no or minimal symptoms) at an early stage.

Who should perform GSEM?

Any biological male who is sexually active can periodically perform GSEM.

Why perform GSEM? Why not just go to a doctor?

Performing GSEM means you are taking care of the health of you and your partner(s). A basic knowledge of how normal male genitalia looks and feels like will help you to easily recognize any signs of change or illness in your genitalia and take action before the condition becomes serious. Once you detect any abnormality - say a small growth suggestive of warts - then you need to go to a doctor. Hence GSEM is NOT a substitute for going to your doctor for a detailed examination or diagnosis.

What do I look for in GSEM? What are the abnormalities?

You should look for any changes or abnormalities in your male genitalia. These may include the appearance of warts, lumps or growths of any kind; ulcers or sores; blisters; areas of pain, inflammation (redness) or itching; and discharge from the penis when ‘milked' from the base. If you have any of these changes, or have any queries you need to contact your doctor. Note that early diagnosis (detection) can lead to an early cure.

How do I do self-exam?

A GSEM may take approximately 5 to 10 minutes to perform.

Ensure that your hands are clean (wash with soap) and dry.

Find a comfortable and private space (bedroom or bathroom) where you will not be disturbed and you feel relaxed.

First, see and feel the penis from the base to the tip – Look for any growth, or ulcer; Feel for any tenderness or thickness.

Then feel the testes – Is there any tenderness or swelling?

Look closely at the pubic hair to find out any pubic lice.

Start gently compressing the penis from its base towards its tip (‘milking') – Do you see any discharge?

Then retract the foreskin (if present) to inspect the inner surface. Is there any ulcer or growth? Can you able to retract your (previously retractable) prepuce completely?

After GSEM, wash your hands with soap.

In individuals with a lot of pubic hair, carefully feeling the male genitalia might give better information then mere self-inspection.

How frequently should I do GSEM?

All sexually active males can perform GSEM at least once a month or if they feel any discomfort in their genitals.